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2 SISFFIT301A :Provide fitness orientation and health screening Client orientation, induction and screening A client who intends to begin an exercise program will have certain needs and expectations. The fitness instructor must identify those needs and expectations to ensure that client goals are achieved. Clients may be experienced or inexperienced, regular or new, active or inactive and of various ages. In addition, clients may be from a range of social, cultural or ethnic backgrounds, have various physical and mental abilities, be unwell; drug affected or emotionally distressed, and may or may not have been previously screened for exercise. In order to identify client needs and expectations, rapport must first be established. Using eye contact, speaking at an appropriate pace and, most importantly, listening to the client will all help with establishment of rapport. A beginner will have no use for a program that is best suited to an experienced weightlifter the program would be too hard, risk injury and most likely cause the client to drop out of exercise. To maximise the establishment of rapport be prepared for the client: Place the client in a comfortable position. Provide written information on the organisation s facilities, products and services. Place yourself in a position with clear access to the client and required materials Provide a friendly and courteous greeting. Introduce yourself and your position to your client The following steps are involved in starting a client on an exercise program: 1. Client orientation includes collection and assessment of information including current physical activity patterns, and identification and clarification of the client s needs and expectations. Determine the perceived benefits clients see themselves deriving from exercise programs Record the clients fitness goals Discuss and record the clients current fitness and lifestyle activities Develop short and long term goals Direct clients to understand and change their behaviors to overcome their own barriers to the continuation of an exercise program Identify the steps involved in establishing a behavioral change that results in long term adherence to an exercise program This is also the time for building/establishing rapport with the client. This rapport can begin during formal or informal meetings with a client. 2

3 It is important to establish rapport with your client to help promote a sense of ease and trust. Although this may sound simple it can be quite difficult, especially when you are faced with someone who may have characteristics that are hard to deal with. Two issues to consider when establishing rapport are: a) The physical setting b) Your communication techniques What you do and say should help your client feel comfortable with the experience. Your professional, caring and sincere attitude should be reflected in both your verbal and body language. Establish rapport with client (positive body language, smile, introduction, relaxed conversation, brief explanation of proceedings, general view of environment) Select an appropriate environment for initial consultation (private, safe, clean and tidy, positive messages) Use effective listening strategies (reflective listening) Select appropriate questions to obtain information about client regarding things such as lifestyle goals, past experiences and potential problems (use a lifestyle questionnaire) Discuss and document preferred activities It is important to establish your client's general fitness requirements during your initial consultation. This information can then be used to develop a fitness program tailored to the client's needs. Learn more about your client's lifestyle by talking about work, family and hobbies. Determine what your client wants to achieve from participation in an exercise program. Bear in mind that different people have different reasons which may be linked to lifestyle issues. Some common reasons for starting a fitness program are: Improve physical fitness Lose weight Improve health and quality of life Cope with stress Establish a support network or social group Feel good and enjoy exercise Other factors that influence the client's needs may include: Past involvement in exercise Reasons for not exercising Leisure activities Preferred physical activities Preferred exercise times Time available for exercise Support that may be required Previous injuries Money available for exercise 3

4 Collection and assessment of information An initial discussion, preferably face-to-face, will be needed between the client and the fitness instructor. You as the fitness instructor should consider how the client is feeling about starting or changing their exercise program. Clients may have a mixture of feelings including feeling nervous, shy, embarrassed, insecure or confident. Also consider what has happened before this point has the client been convinced to join a gym by a salesperson? Or were they dragged along to the gym by a friend or partner, or given an urgent medical referral to commence exercising? These factors can impact on the client s feelings and expectations. Methods or tools that may be used to collect information about the client include: An interview with the client Pre-activity questionnaires A checklist to help classify whether the client should be referred to a doctor prior to commencing an exercise test or program Information from other organisations or professionals, such as past medical records Previous exercise file records Observation of the client including observation of static and dynamic posture during the interview and orientation Checking of written material such as a referral from a doctor Liaising with other professionals who have prescribed an exercise program to this client in the past. The fitness instructor should use professional communication and personable inter-personal skills during the orientation process. This may include: Using appropriate body language, for example, avoid folding your arms Summarising and paraphrasing the words of the client to display attentive listening Demonstrating networking skills, for example, ability to liaise with other fitness instructors in regards to this client, while maintaining confidentiality Ensuring that the consultation method is well timed, professional and appropriate to the exercise experience of the client Seeking feedback from either the client or other relevant personnel, such as fitness instructors, to confirm understanding of information Ensuring the client is given full attention at all times Using appropriate language and tone of voice 4

5 Gathering information about the client usually involves the client completing a form that involves them taking some responsibility for their actions in the event of an accident. The form may be useful for gathering additional details on lifestyle and exercise intentions. This may include things like whether or not the client currently exercises, and if yes, how often and what type of exercise is he or she involved in? The fitness instructor can then discuss information further; for example, what exactly is involved if the client states that they exercise three times per week? Is that simply climbing the stairs at work? Goals and the availability for exercise must also be clarified. For example, if the client can allocate one hour for exercise the fitness instructor should clarify whether this includes travel to and from the gym. Identifying general client fitness requirements The requirements of the client will differ according to the experience of each client. The client may be already committed to a program that is no longer providing results. For example, a client has lost ten kilograms to achieve their first goal of weight loss but now wishes to increase muscle bulk. This will involve modification to the current program, such as increasing the weight and decreasing the repetitions per set, or decreasing the rest time between sets. These decisions will be made on an individual basis for each client. Additional changes to the program may include alterations to the amount of cardiovascular training. A program that is focused on weight loss will consist predominantly of cardiovascular training. A program that is focused on weight loss will consist predominantly of cardiovascular training; a program that is focused on increasing muscle bulk will consist of more weight training. Making program changes can be tricky. Potential problems with program changes include deciphering how much should be changed at any one time. Too many changes in one session or small time frame can cause excessive overload and risk injury. Health screening and a fitness test should be performed prior to implementing any changes. Programs should be progressive, but within reason. For example, an increase in weight of 5-10 per cent in one week is enough to overload most clients. Remember that everyone responds differently to stress and exercise. Too many very hard sessions per week, injury and other overtraining signs and symptoms (for example, excessive muscle soreness and prolonged recovery from exercise sessions) may start to appear. A walk through the gym or fitness facility may be involved in the client orientation. It is important to introduce the client to all areas of the facility even if they are not interested in all aspects of training at that stage. 5

6 This time can also be spent building rapport and increasing the client s comfort level both within the gym and with the fitness instructor. The dress code and other rules and regulations of the facility should be explained to the client at orientation. Requirements of the client The client will be expected to take some responsibility for their progress. This may include examining and reporting on parts of the program that are fun, not so fun, effective and not so effective. The client and the fitness instructor may then liaise in regards to: Modification to the current exercise program Additions to the exercise program Potential problems and solutions Monitoring of the program and progress Making an appointment for a fitness appraisal Once information has been collected and examined you should advise the client of the appropriate action. If an existing medical condition or injury is identified, or the client is taking prescribed medication, you need to recommend they make an appointment to see their allied health professional or medical practitioner. Once you decide to proceed with the fitness appraisal of the client, an appointment should be made. The client should be booked according to facility protocol either in a computer system or manual diary and issued with the date, time and purpose of the appointment and the name of the instructor performing the appraisal. What else does the client expect of the fitness instructor? It is the responsibility of the fitness instructor to pass information about specified products and services available to the client. This may include knowledge of the type of group exercise classes available and the benefits and risks of these classes. The suitability of the classes for clients should be discussed on a case-by-case basis. In some cases, the client may have visited the gym or fitness facility as a result of a promotional pamphlet and the details of this promotion should be made available to staff through training. Have you got enough information? The fitness instructor should always seek feedback on whether the information sought is sufficient to ensure compliance with organisational requirements. The quality and amount of information required should be regularly reviewed. Any changes that need to be made should be documented and incorporated into modifications. 6

7 Of course customer satisfaction is very important to all businesses without it the business would not exist! Customer feedback questionnaires will help discover customer satisfaction statistics. The organisation may hold information about past and current clients. This may include correspondence in the form of faxes, s and computer files. Privacy laws may limit access to some or all of this information. Information that may be held by the organisation may include: Faxes, memos, letters and s Computer databases including customer records, Computer files such as letters and memos Sales records such as monthly forecasts Insurance and membership forms Invoices, Personnel records, Financial figures, Production targets Client Induction Client Induction is the first step in involving a client in a physical activity program. It is common for prospective clients to be anxious about beginning an exercise program, therefore the fitness instructor should attempt to make any new client comfortable in their new surroundings. The information that has been gathered should at all times be treated in a confidential manner. Once this information has been gathered it forms the beginning of the client s file and should be stored appropriately for future reference. When gathering and recording information from a client regarding health or lifestyle, we recommend an interview process where the fitness instructor asks the client a question and then records the answer on the appropriate form. During the process the fitness instructor should speak clearly and confidently while stopping to answer any queries the client may have. It is particularly important that you, as the fitness instructor, do not put words into the client s mouth; rather a questioning technique should be adopted. This has a number of advantages: It formalises the process It allows the fitness instructor to elaborate on or clarify any questions the client does not completely understand. It prevents clients from circling yes or no without actually reading the question It allows clients to answer completely in their own words 7

8 It allows the fitness instructor to record additional information they consider important It affords the fitness instructor time to think about responses being made by he client Suggested steps in client induction: Step 1 Initial consultation Client Questions Health screening Lifestyle information Waiver or release Walk through facility Step 2 Fitness Testing 5 health related components Other components Step 3 Counseling Testing results and interpretation Goal setting Introduction to program 8

9 Step 1: Initial Consultation Clients will form an impression of a facility and instructor within the first couple of minutes of contact. The fitness instructor should adopt a friendly personable attitude and be prepared for the client. Although the client will feel comfortable dealing with the same person on each occasion this may not always be possible, therefore it is good practice to start a new file on each client and make detailed notes as the client progresses. This will make it easy for another instructor to assist the client where required. As fitness instructors become more experienced they tend to take notes in the initial client interview to supplement information gathered on the forms. Always remember that this initial interview should be time effective while gathering the required information. The fitness instructor should be professional, friendly and personable and needs to make sure throughout the interview that the client understands what is going on and can ask questions at any time. During the initial interview it is useful to get a general idea of the client s goals but don t forget that it is difficult to set realistic and achievable goals before fitness testing has been undertaken. At the outset it is important to make the client feel relaxed and confident in your abilities. It may be helpful early in the contact to ask the client if they have any questions or concern that you may be able to help them with. It is important to find out why the client has come to you. Probably the most common reason people will see a fitness instructor is so that they can have someone assist them in achieving their health and fitness goals by telling them what to do and how to do it correctly. They may also need clarification about the many myths that surround health and fitness. During this initial contact the fitness instructor should be making an evaluation as to whether they are the best professional to assist the client in achieving their goals. In some instances it will be wise for you to involve other health care professionals in the overall program to assist the client in achieving their goals. Once the client has had questions answered, you as the fitness instructor need to commence pre-exercise screening with the client. 9

10 Client screening is a critical step in the process of engaging a client in an exercise program and serves five key purposes: Ensures it is safe and appropriate for the client to begin testing and exercise programming Identifies medical conditions Identifies contraindicated activities Helps to fulfill legal and insurance requirements Provides a valuable opportunity for the instructor to further develop a meaningful relationship with a new client Pre-exercise screening should be designed to collect relevant health-related information which may be used to assist in developing an individualised exercise program. There are a number of pre-exercise forms used to collect information, however remember that suitable preexercise screening forms must cover a minimum of five distinct areas: Background information: Questions in this section are used to identify clients. Known Diseases: These are medical conditions the client is aware of Signs and Symptoms: Signs are things the fitness instructor or client can see such as swelling of the ankles. Symptoms these are things the client will report for example pain in the chest. Family History: This section will include cardiac risk factors such as high cholesterol and information asking about relatives conditions. Exercise Intentions: This section should investigate how active the client currently is and how they intend to exercise. Clients who are sedentary and wish to exercise at high intensity are generally at greater risk of those who are already active. What information do we need to collect from a client? Age Family history Gender Current medical conditions Diseases Injuries past or present Signs and symptoms Medications Surgery Exercise intentions 10

11 From this we can identify whether or not the client requires a medical clearance before programming. In general, a pre-exercises form should contain the following information: Name, age and gender of client male over 45, woman over 55? Questions on family history does/did anyone in the family under the age of 60 suffer from heart attack, stroke, raised cholesterol or sudden death? Current/recent medical history medications, post natal, hospital, pregnancy, infectious disease? Previous/current medical history including hypertension, metabolic disease, heart problems (other than coronary heart disease), glandular or rheumatic fever, ulcer or hernia etc. Should the client answer yes to two or more of the above conditions, a medical clearance should be obtained from their regular general practitioner. There are many differing pre-exercise screening forms and software applications available and it is up to the fitness instructor which pre-exercise screening system they choose to adopt. Sports Medicine Australia and the Australian Association for Exercise and Sports Science have adopted guidelines which follow closely the American College of Sports Medicine (Norton et al. 1998). As such, these screening systems may exclude up to 73% of the Australian population from participation until they have obtained a medical clearance, Although the chance of death or severe injury resulting from participation in a correctly designed fitness program is remote, it must be remembered these screening systems significantly reduce the chance of injury of death from participation in a physical fitness program and as such are particularly important. No area on the pre-exercise screening form should be treated as insignificant as the fitness instructor will often be the health professional responsible for detecting an existing underlying condition and referring the client on appropriately. Once the client has completed the pre-exercise screening a judgment will need to be made as to the readiness of the client for participation in subsequent fitness testing and involvement in the exercise program. This is a particularly important step as a mistake here may expose the client to increased health risks from participation in physical activity which, in extreme cases, may result in death. The fitness instructor must make a decision whether to begin testing and programming or whether to send the client to a doctor for a medical clearance. 11

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